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Fetal iGRASP cine CMR assisting in prenatal diagnosis of complicated cardiac malformation with impact on delivery planning

Bhat, Misha LU ; Haris, Kostas LU ; Bidhult, Sebastian LU ; Liuba, Petru LU ; Aletras, Anthony H LU and Hedström, Erik LU (2019) In Clinical Physiology and Functional Imaging
Abstract

Limited visualisation of the fetal heart and vessels by fetal ultrasound due to suboptimal fetal position, patient habitus and skeletal calcification may lead to missed diagnosis, overdiagnosis and parental uncertainty. Counseling and delivery planning may in those cases also be tentative. The recent fetal cardiac magnetic resonance (CMR) reconstruction method utilising tiny golden angle iGRASP (iterative Golden-angle RAdial Sparse Parallel MRI) allows for cine imaging of the fetal heart for use in clinical practice. This case describes an unbalanced common atrioventricular canal where limited ultrasound image quality and visibility of the aortic arch precluded confirming or ruling out presence of a ventricular septal defect. Need of... (More)

Limited visualisation of the fetal heart and vessels by fetal ultrasound due to suboptimal fetal position, patient habitus and skeletal calcification may lead to missed diagnosis, overdiagnosis and parental uncertainty. Counseling and delivery planning may in those cases also be tentative. The recent fetal cardiac magnetic resonance (CMR) reconstruction method utilising tiny golden angle iGRASP (iterative Golden-angle RAdial Sparse Parallel MRI) allows for cine imaging of the fetal heart for use in clinical practice. This case describes an unbalanced common atrioventricular canal where limited ultrasound image quality and visibility of the aortic arch precluded confirming or ruling out presence of a ventricular septal defect. Need of prostaglandins or neonatal intervention was thus uncertain. Cardiovascular magnetic resonance imaging confirmed ultrasound findings and added value by ruling out a significant ventricular septal defect and diagnosing arch hypoplasia. This confirmed the need of patient relocation for delivery at a paediatric cardiothoracic surgery centre and prostaglandins could be initiated before the standard postnatal ultrasound. The applied CMR method can thus improve diagnosis of complicated fetal cardiac malformation and has direct clinical impact. This article is protected by copyright. All rights reserved.

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author
organization
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type
Contribution to journal
publication status
epub
subject
in
Clinical Physiology and Functional Imaging
publisher
Wiley Online Library
external identifiers
  • scopus:85062777872
ISSN
1475-0961
DOI
10.1111/cpf.12566
language
English
LU publication?
yes
id
02e0870f-d55f-4929-8dec-09fc09ef2119
date added to LUP
2019-02-26 21:30:43
date last changed
2019-04-23 04:46:13
@article{02e0870f-d55f-4929-8dec-09fc09ef2119,
  abstract     = {<p>Limited visualisation of the fetal heart and vessels by fetal ultrasound due to suboptimal fetal position, patient habitus and skeletal calcification may lead to missed diagnosis, overdiagnosis and parental uncertainty. Counseling and delivery planning may in those cases also be tentative. The recent fetal cardiac magnetic resonance (CMR) reconstruction method utilising tiny golden angle iGRASP (iterative Golden-angle RAdial Sparse Parallel MRI) allows for cine imaging of the fetal heart for use in clinical practice. This case describes an unbalanced common atrioventricular canal where limited ultrasound image quality and visibility of the aortic arch precluded confirming or ruling out presence of a ventricular septal defect. Need of prostaglandins or neonatal intervention was thus uncertain. Cardiovascular magnetic resonance imaging confirmed ultrasound findings and added value by ruling out a significant ventricular septal defect and diagnosing arch hypoplasia. This confirmed the need of patient relocation for delivery at a paediatric cardiothoracic surgery centre and prostaglandins could be initiated before the standard postnatal ultrasound. The applied CMR method can thus improve diagnosis of complicated fetal cardiac malformation and has direct clinical impact. This article is protected by copyright. All rights reserved.</p>},
  author       = {Bhat, Misha and Haris, Kostas and Bidhult, Sebastian and Liuba, Petru and Aletras, Anthony H and Hedström, Erik},
  issn         = {1475-0961},
  language     = {eng},
  month        = {02},
  publisher    = {Wiley Online Library},
  series       = {Clinical Physiology and Functional Imaging},
  title        = {Fetal iGRASP cine CMR assisting in prenatal diagnosis of complicated cardiac malformation with impact on delivery planning},
  url          = {http://dx.doi.org/10.1111/cpf.12566},
  year         = {2019},
}